Heaney Roisin M, Murray Michael, Heaney Aine M, Doherty Eva M
Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland.
Depatment of Surgery, Mayo University Hospital, Castlebar, Co. Mayo, Ireland.
Ir J Med Sci. 2019 Feb;188(1):259-263. doi: 10.1007/s11845-018-1782-5. Epub 2018 Mar 9.
Obtaining patient consent is a fundamental process in surgical practice and is integral in respecting and safeguarding patient autonomy. It has been reported that the task of consenting patients frequently lies with junior doctors, who have the least experience of the procedure.
To examine the role of interns in the consent process in the Irish context as well as to identify their concerns.
A 12-point questionnaire, assessing interns' experience with surgical consent, was circulated to interns in three Irish university teaching hospitals based in different geographical locations. Interns who had never worked in a surgical team were excluded from the analysis.
Out of 104 interns, 60 interns returned questionnaires. Of these, 58 (96.7%) had consented a patient for a surgical procedure. Forty-four interns (73.3%) had never been supervised by a senior doctor. Of the 58 interns who had obtained surgical consent, six interns (10.3%) reported knowledge of 'all' the steps of the procedure. Only five interns (8.6%) reported that they were aware of all the risks of the procedures and 34 interns (58.6%) reported they knew 'most' of the risks. Twenty-five interns (43%) reported that they had, at some point, been explained the risks of the procedures by a senior colleague.
The majority of interns reported that they had taken consent for a procedure without full knowledge of the procedure and its complications. Supervision or instruction from a senior colleague was reported by a minority.
获取患者同意是外科手术实践中的一个基本过程,对于尊重和维护患者自主权至关重要。据报道,让患者签署同意书的任务常常落在经验最少的初级医生身上。
考察实习医生在爱尔兰背景下的同意书签署过程中的作用,并确定他们所关心的问题。
向位于不同地理位置的三家爱尔兰大学教学医院的实习医生发放了一份包含12个问题的问卷,以评估他们在外科手术同意书签署方面的经验。从未在外科团队工作过的实习医生被排除在分析之外。
在104名实习医生中,有60名返回了问卷。其中,58名(96.7%)曾为患者进行过手术同意书签署。44名实习医生(73.3%)从未得到过上级医生的监督。在58名进行过手术同意书签署的实习医生中,6名(10.3%)表示了解该手术“所有”步骤。只有5名实习医生(8.6%)表示他们知晓该手术的所有风险,34名实习医生(58.6%)表示他们知道“大部分”风险。25名实习医生(43%)报告说他们曾在某个时候由上级同事向他们解释过手术风险。
大多数实习医生报告说,他们在不完全了解手术及其并发症的情况下就为手术获取了同意书。少数实习医生报告得到了上级同事的监督或指导。